HIV Risk: Swollen Lymph Nodes In Armpits, Neck and Groin
by wonderingboy, Sep 11, 2010
Hi Doctors thank you for all your help.

I'm a 23 y/o hetero male and I engaged in unprotected sex on two occasions with the same girl (who I barely know) over two weeks ago. The timeline is as follows.

8/22: Had unprotected vaginal and oral sex with girl for approx 2hrs. She ended up bleeding during encounter.

8/24: Engaged in unprotected vaginal and oral sex again for approx 3hrs.

8/25: Noticed swelling in both armpits, neck, developed a sore throat and fatigue.

8/31: Went to GP was prescribed Suprex for symptoms, got tested for Gonorrhea, Syphilis, Chlamydia, HIV and mono (all came back negative)

9/4: Sore throat disappeared. Armpits sweaty, sore, swollen, and burning (esp at night). Developed pain, sweating, and burning in groin. Testicles extremely sore. All symptoms intensified at night.

9/7: All symptoms persist. Visited Planned Parenthood was examined, told my symptoms might be gonorrhea or chlamydia. Was given a shot of antibiotics and a 10 day prescription for Doxycycline.

9/9: All symptoms persist. Pain in groin seems moderately better but lymph nodes in groin, armpits, and neck still swollen.

9/11: Swelling in neck intensified making swallowing difficult. Armpit swelling persists along with burning and dry skin. Groin remains moderately painful and nodes still swollen.

Over the whole time I've been monitoring my temperature and I have no fever.

My question is do the symptoms for HIV usually present themselves in such an immediate manner?
Do my symptoms seem to point towards HIV?
How long do I need to wait to get tested again for HIV (6 weeks, 3 months, or 6 months?)
Will other diseases/infections take more time to test positive and explain my symptoms?
What's my next step?
I'm trying to keep a level head.
Welcome to the HIV forum.

Acute HIV cannot cause lymph node enlargement or any other symptoms sooner than 10 days after exposure; and if your lymph node enlargements were due to HIV, you would also have fever.  HIV related lymph node enlargements usually are not painful.  The identical symptoms as acute HIV are caused by many conditions, most of them much more common than acute HIV, so even typical symptoms usually are not a useful clue.

Furhter, although you describe lymph node enlargements and various aches and pain, you don't mention whether the clinicians at Planned Parenthood or elsewhere confirmed that your nodes actually are enlarged.  If they are, follow your personal provider(s)' advice about diagnostic tests, treatment, etc.  To your specific questions:

1) HIV symptoms usually begin 10-20 days after exposure, never before 7 days.
2) No.
3) If your PP clinic has the HIV duo test for both HIV antibody and p24 antigen (recently approved in the US, not yet available in all clinics), then a single test at 4 weeks will prove you aren't infected.  If you have a standard antibody test, you could be tested at 4 weeks with about 90-95% accuracy then once again at 6 weeks; or just have a single 6 week test.  With the now-standard antibody tests, it is rarely necessary to test beyond 6 weeks.  But follow your own provider's advice about exact tests and timing.
4) Whatever you have, it isn't an infection you caught during the sexual exposures described.  It is unlikely you have any STD.
5) Next step?  Follow your provider's advice; and you can stop worrying about HIV.  It is very unlikely.

Regards--  HHH, MD

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Member Comments (8)
by wonderingboy, Sep 20, 2010
Thank you for your response. After going over what I posted, I was a little off on my time-line. My symptoms began on the 28th not the 25th, if it makes any difference. My swollen glands (in my neck, armpits, and groin) have been confirmed by my urologist, GP, and PP doctors. No one is able to figure out what is wrong with me. My GP did two tests for mono and both came back negative. While he was doing those tests he also did other blood-work and was able to determine that I do have some sort of virus but did not know what type. Would HIV effects be detected by blood-work related to mono? My symptoms have persisted for over 3 weeks now. I'm worried I have HIV.
For the reasons I gave above, it remains unlikely you have HIV.  You might have mononucleosis of the "heterophile negative" variety, for which standard mono tests are negative.  That would fit with "I do have some sort of virus but did not know what type".  But we don't speculate on this forum about non-HIV explanations for symptoms.

It is now 4 weeks since your sexual exposure, and you should speak with your GP about having HIV testing now.  If the local lab offers the duo (combo) test described above, that would be ideal.  If negative, it will be 100% proof you don't have HIV.  Even an antibody-only test would be helpful, even if not quite definitive.

If your GP doesn't seem up to all this and not particularly familiar with HIV, consider asking for referral to an infectious disease specialist.  (Or if you're in the UK, which might be suggested by your use of "GP" instead of family practice or family medicine, visit your nearest NHS GUM clinic for highly expert evaluation.)
by wonderingboy, Sep 21, 2010
I have an appointment to see a Infectious Disease specialist on thursday. I am in the greater seattle area. Do you think they will have the duo/combo test available? I have recently come down with other symptoms including, diarrhea, dry mouth, cuts on the corners of my mouth, muscle and joint pains, nausea, constant drowsiness. I have trouble eating food and end up feeling sick afterwards. The girl I was with swears that she's clean and said she's getting test results on friday. I phoned my GP and asked him about the mono related bloodwork, he told me that my white and red blood cell count was down so the probability of mono is out the door. I am hoping that the ID specialist will give me some answers on Thursday, I will keep you posted. Thank you
Direct evaluation by an ID specialist in person is always more reliable than anything a distant expert can offer.  Ask these questions when you see the doctor and follow his or her advice.
by wonderingboy, Sep 29, 2010
I got my results from the ID specialist. You were right Doc, my HIV antibody test came back negative. The other bloodwork he did told him that I have had mono recently and my symptoms are attributed to that. I appreciate you helping me out, I would not have found an answer without your advice to consult the ID specialist. To anyone else who reads this post please don't make the same mistake as me and jump to conclusions based on symptoms. As the doctors say only the tests can make the determination. I put myself through extreme paranoia and depression worrying about a disease I had little risk of contracting. Thanks again Dr HHH
You're welcome.  Thanks for your common-sense advice to other forum readers.